The pathophysiological mechanisms responsible for male subfertility/infertility caused by or complicated by genital heat stress remains unclear in many respects. Because seminal plasma creates the environment for the proper functioning of spermatozoa, in this study, we verified the associations among standard spermiograms, seminal biochemical parameters (neutral alpha-glucosidase, fructose, and citric acid) and oxidative stress markers (total antioxidant capacity, catalase activity, superoxide dismutase activity, and malondialdehyde concentration) in distinct entities associated with male infertility with and without long-time exposure to local hyperthermia. We demonstrated that men exposed to prolonged environmental or clinically recognized local heat stress in adulthood may suffer from dysregulation of seminal antioxidant components, which can be directly associated with epididymal and prostate function. The comparative analysis of the studied parameters showed numerous correlations among all biochemical parameters (particularly neutral alpha-glucosidase) with low standard semen quality in almost all the investigated infertile groups. In light of the data obtained in this originally designed study, we conclude that more attention should be paid to the epididymis and accessory gland function in subfertile and infertile men exposed to genital heat stress, especially in the context of novel treatment algorithms (targeted therapies).

The term «lymphatic malformations» (LMs) refers to a wide spectrum of disorders with clinical manifestations that can vary from asymptomatic to life-threatening. LMs are most frequently found in the head and neck, accounting for up to 75 % of all cases [1]. Head and neck LMs result in airway compression, a dangerous complication requiring a tracheostomy, and significant cosmetic deformities [16]. According to a Japanese group of authors, up to 14 % of head and neck LMs can extend to the superior and anterior mediastinum, which increases the risk of airway obstruction [1, 16]. The incidence of abdominal and thoracic LMs is up to 20 % [2] 5 % and 6 % for each type [3], respectively. In some cases, they may be asymptomatic and incidentally diagnosed during a medical examination for other reasons. In 90 % of cases, LMs are diagnosed in pediatric patients by the age of 2 years due to clinical symptoms [3], some of which require urgent medical care. Other life-threatening complications of extensive vascular malformations may be associated with coagulation disorders [4].

Cow's milk protein allergy is a topical issue in pediatrics. The diagnostic algorithm for cow's milk protein allergy includes thorough history taking, examination, physical development assessment, determination of specific cow's milk IgE, and oral food challenge tests.
The study aimed to develop a step-by-step algorithm for conducting oral food challenge tests with milk in young children, taking into account individual indications and risks.
Materials and methods. The task is to diagnose the cow's milk protein allergy in children in the first year of life. It is solved by allergy history taking, examination, assessment of physical development, detection of specific cow's milk IgE and based on the obtained results, oral food challenge test is performed: in age category before reaching one year when the specific IgE is more than 0.7 kU/L, testing is performed in the intensive care unit, if the specific IgE is less than 0.7 kU/L – in a specialized inpatient department.
Patients. The algorithm for diagnosing cow's milk protein allergy in 96 children under 12 months of age was tested in the City Children's Clinical Hospital.
During the oral food challenge test, the dose is increased logarithmically until the desired amount of product is reached, depending on the predicted risk of the reaction. Children at medium risk (specific IgE less than 0.7 kU/L) are tested in a specialized inpatient department by “five steps”, and at high risk (specific IgE greater than 0.7 kU/L) – in the intensive care unit by “eight steps”.
Results. Among 96 children who underwent an oral food challenge test with milk, cow's milk protein allergy was diagnosed in 42 (43.75%). After the oral food challenge test, patients were given further recommendations, of which 27 (64.29%) were transferred to a formula with total protein hydrolysis, and 15 (35.71%) began to take oral tolerance induction (regular administration of acidified milk formula from lower doses to larger).
Conclusions: The developed algorithm for conducting oral food challenge tests with milk in children of the first year of life gives a possibility to personally select the examination technique taking into account the indications and risks. Appropriate preparation for the oral food challenge test enables to correctly conduct it, interpret the results, and develop a therapeutic approach.
Keywords: cow’s milk allergy, food allergy, oral food challenge test. 

Introduction: Patent ductus arteriosus (PDA) is one of the most common cardiovascular problems that occur in preterm infants. This trial aimed to investigate whether acetaminophen is non-inferior to ibuprofen in closing PDA in very preterm infants.

Patients and Methods: A randomized non-inferiority trial was conducted on preterm infants with a gestational age <32 weeks, birth weight <1500 g, postnatal age <72 h, and PDA size >1.5 mm. Infants were randomly assigned to receive either intravenous acetaminophen (n=52) or rectal ibuprofen (n=52). The primary study outcome was the ductus closure within 24 hours after completion of the first and/or second course of pharmacological treatment. Results: The incidence of PDA closure after completion of the first and/or second course of pharmacological treatment was identical 81% (42/52). After the first course of treatment, PDA closed in 37 infants (71%) in the ibuprofen group and 41 patients (79%) in the acetaminophen group (p>0.05). The median age (IQR) at the time of ductus closure was also the same in both groups, 5 (5-6) days. There were no statistically significant differences between the groups in the incidence of severe complications associated with preterm birth and mortality (p>0.05). No side effects related to pharmacological treatment were detected.

Conclusions: Acetaminophen is non-inferior to ibuprofen for the closure of PDA in very preterm infants.

Keywords: patent ductus arteriosus; PDA; acetaminophen; ibuprofen; very preterm infants

The purpose of the work was to study the activity of the carious process in people of different ages using the assessment of the Decayed, Missing, and Filled Teeth and the International Caries Detection and Assessment System index. Materials and methods. The study involved 53 people who were divided into groups: group 1 – 16 people  aged 18 to 25 years, group 2 – 20 people aged 26 to 35 years and group 3 – 17 people aged 36 to 45 years. 
The intensity of caries was determined using the Decayed, Missing, and Filled Teeth index. The International  Caries Detection and Assessment System index was used to assess the activity of carious lesions. Results. The indicators of the Decayed, Missing, and Filled Teeth index in the group of people aged 18-25 years significantly differed (p <0.05) from the indicators in the group of people aged 26-45 years. In the group of people aged 36-45 years the indicators were higher than in the group of people aged 26-45 years, but no significant difference (p˃0.05) was found. In the group of people aged 18-25 years the share of filled teeth was 61.5%, teeth affected by caries were found in 29.4%, and removed teeth – in 9.1%. In the group of people aged 26-45 years, the rate of filled teeth was lower compared to people of the 1st group, the share of carious teeth increased up to 35.0%, and the number of removed teeth increased up to 16.4%. In the group of people aged 36-45 years the share of teeth affected by caries was lower than in the 1st and 2nd groups and was equal to 27.3%, the share of filled teeth was 46.2%, which is lower than in other groups, but the share of removed teeth was the highest of the groups which were examined and was 26.5%. The results indicate a rapid increase in the intensity of caries in patients of main working age, namely persons of the 2nd and 3rd groups compared with persons of young working age of the 1st group. The study of the depth of caries in enamel and dentin according to the International Caries Detection and Assessment System showed that in patients aged 18-25 years, from all teeth which are affected by caries in 71.4% enamel caries was found, which averaged 1.81 ± 0.2 teeth and in 28.6% – dentin lesions, which was an average of 0.68 ± 0.2. In patients aged 26-35 years, codes 1-3 accounted for 41.0% of affected teeth (mean 2.05 ± 0.1 teeth) and code 4-6 accounted for 59.0% of affected teeth (average 2.95 ± 0.2 teeth). In patients of the oldest age group, the number of teeth affected by caries with a code of 1-3 was 27.9% (average of 1.12 ±  0.1 teeth) and with a code of 4-6 was 72.1% (average of 2.88 ± 0.2 teeth). Conclusion. As the age of patients increases, the proportion of filled teeth decreases, but the proportion of removed teeth increases. The highest percentage of teeth affected by caries was found in the 3rd group.
As the age of patients increases, both the average number of carious teeth and the number of teeth with damage dentin increase